Cardiac Ultrasound in Cardiovascular Emergency and Critical Care. A Clinical Consensus Statement of the European Association of Cardiovascular Imaging (EACVI), the Acute CardioVascular Care Association (ACVC) of the ESC, and the European Association of Cardiothoracic Anaesthesia and Intensive Care (EACTAIC).

Cardiac ultrasound (CUS) has emerged as an indispensable bedside diagnostic and monitoring tool in cardiovascular emergencies and critical care, enabling rapid, noninvasive assessment of cardiac structure and function. This multidisciplinary consensus statement, jointly developed by the EACVI, ACVC, and EACTAIC, provides comprehensive, practical guidance on the use of CUS in acute care settings. The document outlines a pathophysiological framework for applying CUS across a wide spectrum of clinical scenarios, including cardiogenic shock, acute myocardial infarction, mechanical complications, acute heart failure, severe valvular disease, pericardial tamponade, pulmonary embolism, and cardiac arrest.

Cardiac imaging in patients with tropical diseases-a scientific statement of the European Association of Cardiovascular Imaging (EACVI) of the European Society of Cardiology and the Cardiovascular Imaging Department of the Brazilian Society of Cardiology (DICSBC).

Tropical diseases (TDs), or neglected TDs, affect over 1 billion subjects globally, primarily in impoverished regions. Despite their impact, these diseases are often overlooked on the global health agenda, with limited resources allocated to their control. TDs are caused by various pathogens, including viruses, protozoa, helminths, and bacteria.

The role of multimodal cardiac imaging in managing electrical storms in severe heart calcifications: a case report.

Background: Intramyocardial calcifications are rare and associated with conditions such as myocardial infarction, rheumatic heart disease, and calcium metabolism disorders. These calcifications carry significant prognostic value, often leading to severe complications like ventricular arrhythmias, increased morbidity, and mortality. They can pose challenges for treatment, especially when ablation is ineffective due to the calcifications acting as physical barriers.

Impact of FFR-CT before coronary angiography on the management of non-culprit lesions among high-risk NSTE-ACS patients.

Recent data suggest that fractional flow reserve derived from coronary computed tomography (FFR-CT) can help select patients with high-risk non-ST-elevation acute coronary syndrome (NSTE-ACS) requiring invasive coronary angiography (ICA). Multiple stenoses are often observed in this population, and while a clear culprit is frequently identified, the management of intermediate lesions remains challenging. The information provided by FFR-CT prior to the ICA could theoretically assist in the management of these lesions.

Comparison of Diagnostic Accuracy of CT Derived Fractional Flow Reserve for Predicting Revascularization.

Purpose: CT-derived fractional-flow-reserve (FFR) is recommended for determining the indication of revascularization. Consensus on optimal fractional-flow-reserve (FFR) measurement methods and lesions is lacking. To investigate the diagnostic accuracy of FFR measurement methods for predicting revascularization and factors affecting FFR measurement methods.

A multicenter analysis of implantable monitoring device-based diagnosis of supraventricular arrhythmia post patent foramen ovale closure: the OCCL-ILR study.

Background: Recent data suggest that the true incidence of atrial fibrillation (AF) after patent foramen ovale (PFO) closure has probably been underestimated, and may differ according to the type of closing device used.

Objectives: On the basis of continuous rhythm monitoring with an implantable device, this study aims to assess the incidence of  supraventricular arrhythmia following PFO closure with the Occlutech PFO device.

Methods: This is a multicentric analysis of consecutive PFO closure patients treated with an Occlutech device between 01/01/2019 and 20/03/2024, with an implantable loop recorder (IRL) (or a pacemaker or implantable cardioverter defibrillator) implanted for at least 3 months preceding the procedure, and with available follow-up for at least 1month post procedure.

Favorable impact of FFR on myocardial revascularization outcomes: Results from an observational real-world registry.

Background: Coronary computed tomography angiography (CCTA)-derived fractional flow reserve (FFR) strategy significantly decreases unnecessary invasive coronary angiography and refines the appropriateness of revascularization decision. The present study aimed to evaluate how FFR guided - strategy impacts outcomes postrevascularization.

Methods: We included patients with suspected obstructive coronary artery disease (OCAD in a registry from 2013 to 2021.

Epicardial adipose tissue, myocardial remodelling and adverse outcomes in asymptomatic aortic stenosis: a post hoc analysis of a randomised controlled trial.

Background: Epicardial adipose tissue represents a metabolically active visceral fat depot that is in direct contact with the left ventricular myocardium. While it is associated with coronary artery disease, little is known regarding its role in aortic stenosis. We sought to investigate the association of epicardial adipose tissue with aortic stenosis severity and progression, myocardial remodelling and function, and mortality in asymptomatic patients with aortic stenosis.

Residential exposome and the risk of coronary obstruction and myocardial ischemia detected by coronary computed tomography.

Background And Aims: To assess independent impacts of air and noise pollution, and residential green exposure on non-invasively derived coronary obstruction and myocardial ischemia.

Methods: Consecutive patients screened by coronary computed tomography angiography (CCTA) for stable chest pain between 01/01/2019 and 31/12/2020 were included in a registry. Exposure associations between residential PM2.

The role of multi-modality imaging in multiple valvular heart diseases: a clinical consensus statement of the European Association of Cardiovascular Imaging of the European Society of Cardiology.

With this document, the European Association of Cardiovascular Imaging provides an Expert Consensus on the role of multi-modality imaging (MMI) in the management of patients with multiple valvular heart disease (MVD). Emphasis is given to the use of MMI to unravel the diagnostic challenges that characterize these patients and to improve risk stratification. Complementing the last European Society of Cardiology and European Association of Cardio-Thoracic Surgery guidelines on valvular heart disease, this Expert Consensus document also outlines how MMI assessment should form an integral part of the multi-disciplinary heart team discussion for patients with MVD to help with complex decision-making regarding the choice and timing of treatment.

The role of multi-modality imaging for the assessment of left atrium and left atrial appendage: a clinical consensus statement of the European Association of Cardiovascular Imaging (EACVI), European Heart Rhythm Association (EHRA) of the European Society of Cardiology (ESC).

Structural, architectural, contractile, or electrophysiological alterations may occur in the left atrium (LA). The concept of LA cardiopathy is supported by accumulating scientific evidence demonstrating that LA remodelling has become a cornerstone diagnostic and prognostic marker. The structure and the function of the LA and left atrial appendage (LAA), which is an integral part of the LA, are key elements for a better understanding of multiple clinical conditions, most notably atrial fibrillation, cardioembolism, heart failure, and mitral valve diseases.

Transcatheter Edge-to-Edge Repair for Severe Isolated Tricuspid Regurgitation: The Tri.Fr Randomized Clinical Trial.

Importance: Correction of tricuspid regurgitation using tricuspid transcatheter edge-to-edge repair (T-TEER) in addition to guideline-directed optimized medical therapy (OMT) may improve clinical outcomes.

Objective: To evaluate the efficacy of T-TEER + OMT vs OMT alone in patients with severe, symptomatic tricuspid regurgitation.

Design, Setting, And Participants: Investigator-initiated, prospective, randomized (1:1) trial evaluating T-TEER + OMT vs OMT alone in adult patients with severe, symptomatic tricuspid regurgitation.

A deep learning based method for left ventricular strain measurements: repeatability and accuracy compared to experienced echocardiographers.

Background: Speckle tracking echocardiography (STE) provides quantification of left ventricular (LV) deformation and is useful in the assessment of LV function. STE is increasingly being used clinically, and every effort to simplify and standardize STE is important. Manual outlining of regions of interest (ROIs) is labor intensive and may influence assessment of strain values.

Usefulness of FFR-CT to exclude haemodynamically significant lesions in high-risk NSTE-ACS.

Background: Coronary computed tomography angiography (CCTA) and fractional flow reserve (FFR) derived from CCTA (FFR-CT) may provide a means of reducing unnecessary invasive coronary angiography (ICA) in patients with suspected non-ST-elevation acute coronary syndromes (NSTE-ACS).

Aims: The aim of this study was to evaluate the capacity of FFR-CT and CCTA to rule out significant lesions in high-risk NSTE-ACS patients, using ICA with invasive FFR as the gold standard.

Methods: High-risk NSTE-ACS patients admitted to 4 European centres were enrolled in this single-arm, prospective core lab-adjudicated study.

Multimodality imaging for the evaluation and management of patients with long-term (durable) left ventricular assist devices.

Left ventricular assist devices (LVADs) are gaining increasing importance as therapeutic strategy in advanced heart failure (HF), not only as bridge to recovery or to transplant but also as destination therapy. Even though long-term LVADs are considered a precious resource to expand the treatment options and improve clinical outcome of these patients, these are limited by peri-operative and post-operative complications, such as device-related infections, haemocompatibility-related events, device mis-positioning, and right ventricular failure. For this reason, a precise pre-operative, peri-operative, and post-operative evaluation of these patients is crucial for the selection of LVAD candidates and the management LVAD recipients.

Systematic hand-held echocardiography in patients hospitalized with acute coronary syndrome.

Aims: Transthoracic echocardiography is recommended in all patients with acute coronary syndrome but is time-consuming and lacks an evidence base. We aimed to assess the feasibility, diagnostic accuracy, and time efficiency of hand-held echocardiography in patients with acute coronary syndrome and describe the impact of echocardiography on clinical management in this setting.

Methods And Results: Patients with acute coronary syndrome underwent both hand-held and transthoracic echocardiographies with agreement between key imaging parameters assessed using kappa statistics.